Briefing Detail Page

Affordability and Health Reform: If We Mandate, Will They (and Can They) Pay?

Friday, November 20, 2009

The health reform proposals being considered in both houses may impose responsibilities on both individuals and employers to have, and help pay for, coverage.

Subsidies for some small businesses and for individuals with incomes up to 400 percent of the federal poverty level have been proposed. But will individuals and businesses be able to pay the amounts required of them above the subsidies? If those costs are onerous, Congress may exempt many people from the coverage requirement or significantly reduce the penalties for noncompliance.

If that occurs, will enough healthy individuals purchase new coverage to adequately spread risk? How generous will subsidies in the final reform package be? What costs – both premiums and out-of-pocket – will individuals and families face? How will small employers be able to afford coverage for their employees?

To address these questions and others, the Alliance for Health Reform and The Commonwealth Fund sponsored a November 20 briefing. Panelists were: Sara Collins of The Commonwealth Fund, DeAnn Friedholm of Consumers Union and Stuart Butler of the Heritage Foundation. Ed Howard of the Alliance and Rachel Nuzum of The Fund co-moderated.

Sara Collins, vice president for affordable health insurance at The Commonwealth Fund, compares the House and Senate reform bills in areas such as premium subsidies and out-of-pocket costs. From the Nov. 20 briefing cosponsored by the Fund.

Stuart Butler, vice president for domestic and economic policy studies at the Heritage Foundation, notes that the House and Senate health reform bills could reduce wages for some employees and could make it harder to fund other priorities. From the Nov. 20 briefing cosponsored by The Commonwealth Fund. (15 min.)

DeAnn Friedholm, director of health care reform for Consumers Union, says reformers should focus on how real people are faring in today's health care system and how they will fare under a reformed system. From the Nov. 20 briefing cosponsored by The Commonwealth Fund. (15 min.)

Webcast: The Emerging Biosimilars Market

Open Enrollment Preview: Checking the Vitals of the Marketplaces

The Affordable Care Act's health insurance marketplaces rely on robust competition to control costs and to provide consumer choice. But the decisions of several large insurers to scale back their 2017 marketplace participation, and the failure of many health insurance co-ops will leave marketplace shoppers in many states with fewer choices than they had in 2016. Furthermore, those insurers remaining in the exchanges have often found their marketplace customers to be less healthy than they projected, and they are raising premiums in response. Our briefing focuses on these trends, what they mean for the long-term viability of the marketplaces, and what public policy steps can be taken to bring more healthy people into the risk pool and to encourage insurer participation in the individual market.